How to overcome depression (translated)

By Leonard Cammer

- This edition is unique;
- The translation is completely original and was carried out for the Ale. Mar. SAS;
- All rights reserved.

You may want to read this book because one of your family members has entered a crisis. It could be your mother, sister, uncle, or any of the family members, and you may have been wondering for weeks or months what was wrong. Your family member is always far away from everything and everyone, and as you look at him, immersed in his deep melancholy, you get the feeling that life has come to a dead end for him. You may begin to think that you are the cause of this particular mood, that you are somehow to blame. What is happening? Your family member is ill with depression. Yes, ill. Depression is not a mysterious intrusion of gods or demons, it is an illness, just like a heart or lung disorder, or any other illness you can think of. Paradoxically, however, this can be a cause for optimism. Paradoxically, however, this can be cause for optimism. As long as it is an insoluble conundrum you can only derive frustration. Once it becomes a precisely definable illness, it can be dealt with as such. Most depressed people recover, because it is a disorder that can be treated with a very good chance of success. However, there is one condition: that the help of the family should be an integral part of the recovery process. And it was the numerous meetings with many families, the questions and answers given, that provided the material for this book. In the course of this book, the author has aimed at a fundamental goal: to present facts that will enable you to cope with and understand your family member's condition, wherever he or she is treated, during and after treatment, and even before seeking medical advice. Treatment can do a great deal for the depressed person, but you yourself must play a role that is often decisive. If this book succeeds in breaking down the wall of hearsay surrounding depression and in relieving the family of the anguish into which it is thrown when one of its members suffers from this illness, if it can help to bring the depressed person back to a normal life, it will have achieved its aim.

• Language: English
• Publisher: Anna Ruggieri
• Release date: Jul 15, 2021
• ISBN: 9788892864566

Book preview

PART ONE - UNDERSTANDING DEPRESSION

I. WHAT IS DEPRESSION?

Perhaps you are reading this book because one of your family members has entered a crisis. It could be your mother, sister, uncle, or any of the family members, and you may have been wondering for weeks or months what was wrong. I am sure that you have also been trying to bring this person out of his or her despondent state, suggesting walks or film shows, and begging friends to come and visit, to see if they could cheer him or her up a little.

But you see no results. Your family member is always far away from everything and everyone, and as you watch him, immersed in his deep melancholy, you get the feeling that life has come to a dead end for him. You remember that once the sister of a friend of yours went through a period of this kind; you did not pay much attention to it then, but now that it touches you more closely you are bewildered by it, and begin to wonder what could be the cause of such a condition. It may even be that, if you are like many people I have had occasion to meet, you begin to think that you are the cause of that particular state of mind, that in some way you are to blame.

What is happening to us?

Discontent enters your home. The opinions of family members are divided. Everyone has a say in what should or should not be done, and arguments and quarrels ensue. If there are children in the family, they feel the general uneasiness and become capricious and intractable. In short, what you are witnessing is the process of disintegration a family can go through when one of its members falls victim to a state of depression and there is no one to decide on a clear course of action.

At this point you may feel shaken and confused. How long is this going to last? And what is really wrong?

Your family member is suffering from depression

Yes, ill. For depression is not a mysterious intrusion of gods or demons, as many once believed. It is a disease, just like a heart or lung disorder, or any of the diseases you can think of.

Paradoxically, however, this can be a reason for optimism. As long as it is an insoluble conundrum, you can only derive frustration. Once it becomes a precisely definable disease, it can be dealt with as such. It may seem a depressing prospect ('a thing in the head' may have been your first distressing association), but please believe that it is by no means the end of the world. Most depressed people recover, because it is a disorder that can be treated with a very good chance of success. However, this is on one condition: that the help of the family is an integral part of the healing process.

Depression is not a product of modern times

This illness has been known to mankind since the beginning of written history. In the Bible, there are frequent descriptions of people distraught with grief, or of the anguished feelings of those who have lost faith in God and in themselves, and have lost all hope for the future.

In the fourth century BC, Hippocrates, the father of medicine, described four types of human temperament, one of which was the melancholic (depressed) character. The term melancholia is still used to characterise the depressed person's condition of despondency and mistrust.

Depression was also a known phenomenon in the Middle Ages, although, as in antiquity, it was attributed to the negative influence of some evil force. It was only towards the end of the 18th century that more extensive studies in institutions and hospitals specialising in the treatment of mental disorders revealed the medical nature of mental disorders.

Today we can attribute depression to the sum of the effects of certain biological and social factors which, in a complex context, adversely affect the functions of the individual nervous system. The depressive effect on the individual's activities in turn changes behaviour, feelings and mental processes. The totality of these dysfunctions gives the picture of the disease we call depression.

Depression strikes without regard

If you are told, for example, that your brother-in-law suffers from depression, don't rush to say: 'Oh, no, not Giovanni. He is too intelligent. He couldn't let himself go like that. Or, if it is your Aunt Giovanna, whom you adore: Impossible. She's always so cheerful, in such a good mood. She wouldn't let herself be depressed by anything.

This is absolutely not true. Depression can affect anyone - a housewife, a taxi driver, a businessman, a teacher, a gambler, an actress, a bricklayer, a shop assistant, a university student, a longshoreman, and so on. It appears in balanced adults as well as in neurotics and children. It can strike at every level of the economic, intellectual and social ladder, and in every personality type. One cannot simply close one's eyes to a phenomenon of this magnitude.

There are various types of depression, which I will discuss in the chapters to come, case by case. I would like to limit myself here to briefly outlining their general characteristics in order to facilitate the reader's understanding of certain passages.

Depression starts with a bad mood

In the introductory paragraphs I mentioned the occasional periods of bad mood that we all go through from time to time. But when these periods last and you can't get over them, and if your everyday life begins to be affected, they can lead to depression proper.

If the period of bad mood is prolonged

The sadness that pervades the person may already constitute the core of depression. The person in this condition becomes aware of his or her feelings, and may ask in despair: 'Why do I have to feel so bad?

Even when the depressed person is not aware of the particular quality of his or her emotional situation, he or she still feels that something is wrong, something is pulling him or her down. And it can be expressed more or less like this: 'I feel tired, heavy'.

The feeling of heaviness means exhaustion, exhaustion. People in this state can spend their days dragging themselves from one place to another, wondering how they can get out of it. If the depressive state is more advanced, he may even refrain from moving at all. It is easy to notice his indolence, because the slightest obstacle becomes insurmountable in his eyes. His thinking faculties seem to be dulled, and his conversation has sudden gaps, absences. At the same time he may continue to complain: 'I feel restless, nervous'.

The mental suffering of depression

It is a psychic state with a very special emotional quality, a mixture of anguish, despair, self-loathing and intense feelings of guilt mixed with anger and fear. This mental pain can also manifest itself as agitation and despair. The sufferer claims that he or she never wanted to be born, or that he or she would like to escape existence.

The physical state of depression

Depression is accompanied by numerous physical reactions, but in almost all cases these are functional impairments (see Chapter VII for an extensive discussion of this term). Your family member may complain of discomfort and pain in the bones or joints, feelings of nausea and dizziness, heartburn, feelings of pressure on the head, or various other physical symptoms that do not, however, appear to be related to an illness on physical examination. Nevertheless, there is something wrong with his physical state, even if it is not something that X-rays can reveal, as depression as an active disturbance of nerve functions can give rise to physical symptoms.

In other words, the nervous system, which is a physical system and part of the body, may experience certain difficulties in functioning. Neural circuits are disturbed and inhibited because brain chemistry does not take place with the balance required for a harmonious emotional process.

Whether depression, however, is understood as a physical disorder or an emotional disorder is a purely academic question. From a technical point of view, one or the other or both may be true. The most important thing is that in each case there is a tendency to think of depression as a nervous condition, particularly in the expression 'nervous breakdown'. Have you not found yourself repeating these very words?

DEPRESSION AND NERVOUS EXHAUSTION

Allow me here an analogy. When someone says 'I've caught a virus', the meaning of this expression can range from the common cold to sinusitis to an attack of diarrhoea. Similarly, the colloquial 'nervous breakdown' can mean any kind of negative emotional experience.

One of my patients described to me the mild depression that followed the break-up of her engagement as a terrible nervous breakdown. Another patient, who had gone through a severe (though short-lived) psychotic depression accompanied by collapses, spoke of it as a slight nervous breakdown... nothing serious.

What I think I can say is that when people generally talk about 'nervous breakdown' what they are really referring to is an emotional disturbance that is so serious that it gets in the way of normal work and everyday life. In this respect, the definition is correct. Depression that distracts a person from his or her responsibilities can certainly be referred to as a nervous breakdown. But this term is still too vague, too general, to be of any use. What I would like to do, however, is to suggest a better method of understanding what happens in nervous breakdown which finds its final outlet in the depressive state. First, therefore, I will describe the functioning of the nervous (or tensional) energy system.

Tensional (nervous) energy in depression

Each of us moves, thinks, works, feels and so on, thanks to the constant influx of energy that the body can provide as a result of assimilating food.

In this case it is caloric energy, produced by the muscles.

But before this can happen, the brain and the nervous system, in coordination with the various glandular secretions and other chemical processes, must activate the muscles by means of tension energy.

It is a process that can be compared to the operation of a car engine. The calorific fuel in this case is petrol, but it is an electrical system consisting of a generator, spark plugs and distributor that provides the controlled energy that ignites the fuel. These two systems must work in close coordination.

At each successive moment of our day we discharge (consume) a certain amount of tensional energy. This is a normal fact. None of us could function as an organism in the absence of tensional energy, or even following a drop in this energy below a certain level, which can vary from individual to individual. If we want to move forward we must have, so to speak, a well warmed-up engine and the gear engaged. The crux of the matter with regard to tensional energy is therefore: how much of it do we produce, and how do we use it?

Some people produce and distribute their daily quota of energy wisely, thus managing to perform all their tasks. These people arrive at the end of a normal day with a reasonable level of tiredness.

On the other hand, one may be faced with the case of a person who produces a normal amount of tensional energy, but discharges it excessively, and thus exhausts it too quickly.

In another case, a person with a normal tension threshold may find himself in a situation of prolonged stress: the bitterness (so to speak) of the 'struggle for survival' wears him down and oppresses him more and more; in this way he consumes increasing amounts of tension energy to sustain the competitive situation, and the result is a state of chronic fatigue.

In yet another case, the person may produce an excessive amount of tensional energy without being able to discharge it adequately. At first a whole series of psychosomatic symptoms may appear; but later, in trying to cope with the symptoms, they too will reach exhaustion.

In the course of days, weeks, or months these people will dissipate ever-increasing amounts of tension energy, either by the excessive or uncontrolled expenditure of their emotions; or, conversely, by accumulating these emotions within themselves, only to see them transformed into physical ailments. Eventually every reserve of emotional strength will dry up; or, in other words, following the definition I gave in another book, a depletion of adaptive energy will occur.

We all need this particular type of energy in order to adapt to the various situations that life presents us with at each successive moment. If the individual loses or exhausts his or her ability to adapt, a depressive state results. (See Chapter V for a further discussion of adaptive energy).

Depression, therefore, indicates a failure of the entire individual being to adapt to the stresses of life. This does not mean that the person affected should be blamed for it. Rather, we say that his or her system for transforming tensional energy is no longer able to function as it should, and that the result of this is depression. The machine is worn out, exhausted; from this follows 'nervous exhaustion'.

CORRELATION BETWEEN ANXIETY, FEAR AND ANGER

If you try to understand depression in its deepest sense, the underlying cause of your family member's disorder is a nervous imbalance.

However, this illness can be related to three other components, namely reactions of anxiety, fear and anger. In most cases, there is a tendency to cover these emotional reactions with depression, and to use the term 'nervousness' or 'excessive tension' to describe all these unpleasant feelings. Example. A woman comes to me for counselling, and at first she doesn't say anything like: 'doctor, I am depressed'. Instead, her description will be: 'I am so nervous, I am afraid to go out alone' (fear). The idea of coming here worried me. I had to have my son bring me because I was upset (anxiety). The smallest things make me afraid (anxiety and fear again). And when I am in this state I get angry, and I take it out on others too (anger).

The son confirms his words. When these statements are finally confronted and analysed, what becomes clear is the depressive state underlying such emotional reactions and the related depletion of the adaptation reserves.

In order to recognise and understand depression, it is essential that you are not led astray by the emotions linked to it. That is why you need to know the role they play, both under normal conditions and when they are overused.

Anxiety, fear and anger under normal conditions

In general, the emotions produced by the nervous system are an entirely normal fact that has its own specific usefulness. Each has the specific task of protecting us in certain stressful conditions, thus ensuring our survival. Thus, when some threat is brought to our life or safety, one of these emotions is mobilised in order to push us to act in directions that will allow us to escape the threat.

Anxiety, under normal conditions, mobilises us to make decisions and take a constructive course of action. A person, for example, feels anxious about his job, and anticipates the possibility of dismissal. The normal reaction is for this person to respond to the anxiety by taking some work home, studying the problems in the field, or trying to increase his skills and abilities. Anxiety thus helps him to secure his job.

Fear also has its uses. It causes us to retreat until the danger has passed. A person may be afraid to drive a car in heavy traffic if he thinks he might panic and lose control. He will therefore avoid busy arteries until he is sufficiently familiar with his vehicle. Fear can also prevent a person from acting impulsively in areas where he feels immature or lacks adequate knowledge. In this way he will gain time, and be able to accumulate more experience.

Anger is also a protective factor. There are many situations in life in which we find that we have to fight for our rights and our safety. Anger sharpens our senses for this purpose. A soldier may not realise that the real reason for his hatred of the enemy lies in a biological mechanism that enables him to cope effectively with the dangerous situation, but that is exactly what it is about: anger merely mobilises his adaptive energy for self-preservation.

However, one can overreact

In fact, it may be that we develop too much anxiety, too many fears, and that the anger we feel in certain situations clearly oversteps the mark. This happens when the person can no longer cope with the threats that seem to be hanging over them.

An illness - of any kind - is indeed a threat. If this illness is depression, the individual will react as to any other illness with anxiety, fear and anger that often grow to uncontrollable proportions.

How anxiety, fear and anger manifest themselves in depression

Anxiety manifests itself in the form of restlessness and panic attacks. The person always tends to expect the worst, feels nervous and uneasy about the slightest event. He or she is always on tenterhooks, and the physical symptoms of anxiety such as sweaty palms, headaches, palpitations, etc. also appear.

Fear is manifested by the person's refusal to be alone, and at the same time by his withdrawal into himself when he is among people. Fears of failure are also expressed. I should quit my job, they will fire me anyway, or I'd better give up that business. I'll never get it done.

Anger is expressed as rage against the disease. The person expresses self-destructive intentions: he/she would like to slap him/herself, hurt him/herself. He has frequent outbursts of anger, during which he directs his sarcasm (and sometimes even physical attacks) at anyone in range. She may even decide that they are part of a conspiracy to persecute and destroy her, and that they are plotting to do so.

It is of paramount importance that you do not get sidetracked by such manifestations of anxiety, fear and anger and conclude that your family member is perhaps throwing a tantrum or playing